Penis Flashcards
Balanoposthitis
Candida albicans, anaerobic bacteria, Gardnerella, pyogenic bacteria
Poor hygiene – accumulation of desquamated epithelial cells, sweat, debris (smegma) – local irritant
• Inflammatory scarring → phimosis
uncircumsized
Condyloma Acuminatum
HPV- 6, 11
- Coronal sulcus, inner surface of prepuce
- Single or multiple sessile or pedunculated, red papillary excrescences
- Branching, villous papillary connective tissue stroma covered with epithelium with acanthosis (superficial hyperkeratosis and thickening of epidermis); no dysplasia
- Koilocytosis – vacuolization of squamous cells
Recurrent
Wart on moist mucocutaneous surface of external genitals
Peyronie Disease
• Fibrous bands involving corpus cavernosum
Penile curvature, pain with intercourse
Bowen disease
- Hyperproliferative epidermis, numerous mitoses, some atypical
- Dysplastic cells with large hyperchromatic nuclei, lack orderly maturation
- Dermal-epidermal border sharply delinated – intact BM
Single or multiple shiny red, velvety plaques on shaft, glans, prepuce, scrotum
>35 yo
10% transform to squamous cell carcinoma over many years
Bowenoid papulosis
HPV 16
- Never becomes invasive carcinoma
- Spontaneously regress
Sexually active adults
Multiple reddish-brown popular lesions
Squamous cell carcinoma of penis
Poor genital hygiene (smegma), high risk HPV infection (16, 18)
- Begins on glands or inner surface of prepuce near coronal sulcus
- Papillary pattern: cauliflower like fungating mass
- flat pattern: areas of epithelial thickening with graying, fissuring mucosal surface → ulcerating papule
- Varying degress of differentiation
- Verrucous carcinoma – exophytic, well differentatied variant, locally invasive, rare mets.
- Other subtypes: basaloid, warty, papillary
Nonpainful until secondary ulceration/infection
Mets to inguinal LN early
40-70 yo
w/o LN: 66% 5 yr survival; with LN 27% 5 yr survival Circumcision – protective
Smoking risk factor
